Eczema on hands treatment
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Effective Treatments for Eczema on Hands
Overview of Hand Eczema
Hand eczema is a prevalent and chronic skin condition characterized by inflammation, itching, and discomfort. It significantly impacts the quality of life, often leading to social stigma and impaired work functioning 12. The condition can be challenging to manage due to its chronic and relapsing nature, necessitating a variety of treatment approaches 12.
Topical Treatments for Hand Eczema
Corticosteroids and Calcineurin Inhibitors
Topical corticosteroids are a cornerstone in the treatment of hand eczema. Clobetasol propionate 0.05% foam has shown efficacy in improving symptoms, although it may cause adverse effects like burning and pruritus at the application site . Mometasone furoate cream, used thrice weekly, has also demonstrated slight improvements in symptom control . Calcineurin inhibitors like tacrolimus 0.1% are effective in reducing symptoms, though they may cause mild application site reactions .
Barrier-Strengthening Moisturizers
Moisturizers, particularly those with barrier-strengthening properties like 5% urea, can prolong the disease-free interval in patients with controlled hand eczema. Studies have shown that using such moisturizers can significantly delay the relapse of eczema compared to no treatment .
Systemic Treatments for Severe Cases
Alitretinoin and Cyclosporin
For moderate to severe chronic hand eczema, systemic treatments are often required. Alitretinoin, available in 10 mg and 30 mg doses, has been effective in controlling symptoms and is generally well-tolerated, although higher doses may increase the risk of headaches . Cyclosporin has also shown promise in improving symptoms, though it carries a risk of adverse events like dizziness .
Emerging Systemic Therapies
New systemic therapies are being explored, including IL-4/IL-13 inhibitors and Janus Kinase (JAK) inhibitors. Drugs like dupilumab and ruxolitinib are currently under investigation and show potential due to their improved efficacy and safety profiles 36.
Phototherapy Options
PUVA and UVB Treatments
Phototherapy, particularly PUVA (psoralen combined with ultraviolet A), has been effective in treating chronic hand eczema. PUVA has shown superior results compared to narrow-band UVB, although both treatments can lead to significant improvements 29. However, PUVA treatment is associated with a higher relapse rate within three months .
Adjunctive Therapies
Paraffin Bath Therapy
Paraffin bath therapy, when used in conjunction with routine skin care, has demonstrated significant improvements in both the severity of eczema symptoms and the quality of life for patients. This therapy involves immersing the hands in warm paraffin wax, which helps to soothe and moisturize the skin .
Behavioral Interventions
Behavioral interventions, such as text messaging to promote preventive behaviors and medication adherence, have also been explored. These interventions can be effective in managing irritant contact dermatitis, the most common type of hand eczema .
Conclusion
The treatment of hand eczema requires a multifaceted approach, combining topical, systemic, and adjunctive therapies. While traditional treatments like corticosteroids and moisturizers remain essential, emerging therapies such as biologics and JAK inhibitors offer new hope for patients with severe and chronic conditions. Phototherapy and behavioral interventions further enhance the management strategies, providing comprehensive care for those affected by this challenging condition.
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